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9909-108 (SFD)LICENSED CONTRACTOR DECLARATION --I-hereby affirm under penalty of perjury that I am licensed under provisions of Cliapter 9 (commencing with Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect. License # Lic. Class Exp. Date 1 V31 f 1110 Date Signature of Contractor OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason: ' ( ) I, as owner of the property, or my. employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044; Business &:Professionals Code). (x) I, as owner of the property, am exclusively contracting with licensed contractors to construct the..project (Sec. 7044, Business & Professionals Code - . () am exempt under Section B&P.C, fQr this ason ate Sigriature of Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: () I have and will _maintain a certificate of consent to self -insure for workers' compensation, as. provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit -is issued. ( ) I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.' My workers' compensation insurance carrier & policy no. are: Carrier Policy No. (This section need not be completed if the permit valuation is for $100,00 or less). (� I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subi cR to the workers' compensation provisions of Section 3700 of the Labor code �I shall forthwith comply with tho a provisio s. ate!~ L_11— Applicant �"`Ilk Warning: Failure to secure Workers' Compensation coverage is unlawful and shall subject an employer to criminal' penalties and civil'fines up to $100,000, in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney's fees. IMPORTANT Application is hereby made to the Director of Building. and Safety for a permit subject. to the conditions and restrictions set forth on his application. 1. Each person upon whose behalf this application is made & each person at whose request and for whose benefit work is performed under or pursuant.to any permit issued as a result of this applicaton agrees to, & shall, indemnify & hold harmless the City of La Quinta, its officers,. agents and employees. 2. Any permit issued as a result of this application becomes null and void if work is not commenced within 180 days from date of issuance of such permit, or cessation'of work for 180 days will subject permit to cancellation. I certify that I have read this application and state that the above information is correct. I agree to comply. with all City, and State laws relating to the building construction, and hereby authorize representatives of this City to enter upon the above-mentioned property for inspection purposes. (signature (Owner/Agent) Date :29 BUILDING PERMIT PERMIT# DATE / VALUATION 1.7f+1 _LOT 38 TRACT . 211W-67 aa� �tAJOB SITE' ADDRESS .'r9.t�..9^B5 CLL�i��!T � OVE, APN 7691-180-020 OWNER CONTRACTOR /DESIGNER /ENGINEER , t31271, iT.) INI:113. ftJMSf.'YiV CPNSA41RTION 19.150 Gs`eEN I :2f N ;' 0R. 77-16x22 COUNTRY CLUB DR_ Bk00Kf?1 LD W1 52;W5 CA 9.221.1 5285 USE OF ,PERMIT 1ppAliFAMILY 4yNi LL - SF D - .N0 BLOM !!7r>LLS OR POOL. _'X3W.f NCP_ W A i i ikll FEIDERJU4 "i`PFt;fiEt,,"W'S, INIC;L€Jf31N0'1"TitiftP L7MCf�St.l'a1: %.G',h(`: i1:;ry A.t;'f' Uf:' .I973 Qfr 0.3.G. 4 1.531, .E'.I.' S:EQ.)'IF AF ILICABI,-F, 18.!'J!Q`U1 fT,- 4.•17:1 E-Eridr'9 l..tC1LVi$1r/�+.�Lw.'I.TL"V .&,fs3.0t0 f;;F iE't'7I;C,.6lJ1ra.F+.'11{:.� l�i.•e'9t1 �� "SITI�t�'ATf4 D COST OF (.7.'0NVPW&"'YTGN PERMIT FEE SUMA^ k -w -V � RIVF 401-oW.41..8-0 a) st,M&i0 Yui, r�l'd r,•7-ffir'f :, r"�Go ! (j d •.d}fJft..d;�'�-� � � ,�A %. � t�`�. I.y tyreiyEl))))*tl����#LI(2s� ...p6:>(►-pQgjty}�-�2�f�•//i)¢IJJli�pai.4py.•yy.ft(i ELECTRIC FEEa'9.J1:'-Vn)U W(,T,tkiArN0 X1% 101,.000-�'•9-wo e't.3 i_�Tdt i' '9.C7f'sC�ib Z ?r _0X i+3i'1.Afs :JRADI F€S)i E 101t.�1Q- j2�_G(A) t2o.iw D3�Va.0i1ER IMPM-11 Ff a? :t. ►tlF.fJ+a ART 04 $?.Vt3LX' PdaA(7E9 - RE-SiL 7W-s�f�i3 255-000 'L .t; s 'r}.�:-r�,I?: �5c,.ct� r •4 t~o. d4�� ' �H $� ��8 DA NOW S4y"733.22 ,'Rl%19T RECEIPT DATE BY DATE FINALED INSPECTOR INSPECTION RECORD �+ OPERATION DATE INSPECTOR OPERATION DATE 4NSPECTOR BUILDING APPROVALS MECHANICAL APPROVALS Set Backs Underground Ducts Forms & Footings Ducts Slab Grade Return Air Steel Roof Deck r� /�/� / Combustion Air Exhaust Fans O.K. to Wrap ( ` Q_�j F.A.U. Framing 3 v /_ Compressor Insulation T y Vents Fireplace P.L. -2 ,/ / - � �_ Grills Fireplace T.O. 2^ '� Fans & Controls Party Wall Insulation Condensate Lines Party Wall Firewall Exterior Lath Drywall - Int. Lathu� 949 a- Qg s -(%IFcti Final Final Qea POOLS - SPAS BLOCKWALL r"PFROVALS Steel Set Backs Electric Bond Footings Main Drain Bond Beam Approval to Cover Equipment Location Underground Electric Underground Plbg. Test Final Gas Piping PLUMBING APPROVALS Gas Test Electric Final Waste Lines Heater Final Water Piping / Plumbing Final Plumbing Top Out Equipment Enclosure Shower Pans O.K. for Finish Plaster Sewer Lateral Pool Cover Sewer Connection= r�. s . Encapsulation Gas Piping Gas Tei Appliances Final COMMENTS: CX-) `S 7 Final Utility Notice r aCi 17 (Gas) ELECTRICAL AP ROVALS Temp. Power Pole Underground Conduit Rough Wiring Low Voltage Wiring Fixtures `Main Service Sub Panels Exterior Receptacles G.F.I. Smoke Detectors Temp. Use of Power Final Utility Notice (Perm) 6vQF7 .: �' "_ ,._;.,.,-.+•.rr.;r.�.r � u:. ,.� �wrr rr`Y „1�•.,, '"�v .... r.' �.. .._ �."'r�•^ � vr',rw.. r� �..'r•r,. , t T.'..i� � ti .. r _. _4+, � 'c it"' 7i: �' .1 . « +lHW yil% • �IGGlf'I�Iii(/ P.O. BOX 1504 -APPLICATION ONLY Building ✓ �"��'fl�J '�p„ n , UINT CALLE CALIFORNIATAMPIO Address �t �-/ t..,U 1/`t'/ LA QUINTA, ORNIA 92253 vfvn er ^ r Mail n BUILDING: TYPE'CONST. OCC. GRP.5 AddressI� , Legal Description�Ci t Ci�J Cont rac orP ! �/�A � roject Description Address City . Zip ITel. State Lic. City & Classif. Lic. # Sq. Ft. �' rr ��C N ` No. Dw. Size V tL1 ✓ 3 Stories ries Units Arch., Engr., DesignerV64 W` New Add ❑ Alter ❑ Repair ❑ Demolition ❑ � . r A 1111 Zi State Lic. #,� LICENSED CONTRACTOR'S DECLARATION f I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. SIGNATU DATE OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractors License Law for the following reason: (Sea 7031.5.Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, or that. he is exempt therefrom, and the basis for thealleged exemption. Any violation of Section 7031.5 by 'any applicant for a permh subjects the applicant to a civil penalty of not more than five hundred dollars ($500). l: I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044, Buisness and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale.) 11 I, as owner of the property, am exclusively contracting with licensed contractors to con- struct the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law.) i 7 1 am exempt under Sec. B. & P.C. for this reason Date owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.) Policy No. Company n Copy is filed with the city. O Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit is for one hundred dollars ($100) valuation or less.) I certify that in the performance of the work for which this permit is issued, I shall not L mploy any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Owner NOTICE TO APPLICANT: g, after making this Certificate of Exemption you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code.) Lender's Name Lender's Address This is a building permit when properly filled out, signed and validated, and is subject to expiration it work thereunder is suspended for 180 days. I certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize representatives -of this city to enter the above- mentioned property for inspection purposes. Signature of applicant Date Mailing Address City, State, Zip SEP 0 8 1 � � � �,11 �/'t T1s! U � t � 1 ► Estimated PERMIT AMOUNT Plan Chk. Dep. Plan Chk. Bal. Const. (; Mech. Electrical Plumbing S.M.I. Grading Driveway Enc. Infrastructure TOTAL REMARKS ZONE: BY: Minimum Setback Distances: Front Setback from Center Line Rear Setback from Rear Prop. Line Side Street Setback from Center Line Side Setback from Property Line FINAL DATE INSPECTOR ' Issued by: Date Permit Validated by: Validation: WHITE = FINANCE YELLOW = APPLICANT PINK = BUILDING DIVISION OCT, -28' 99 (THU) 12 : 03 10/28/96 11;57 w Pm �e FATCO ESCROW D f 1"I S I ON V NalIrf Wn Me Company a 3130939 Lae" We.° E'1906 V ifI awwre MAIL To OsTti d A. Hall . lotharke a. Well 14950 Olen Nervy Prive >�e_lda uut_ 59045 MAM TAX 6TATZMrRM lbi'�®'�6"' VTT ' I* 5o &Alae As A MM _ """Mph � � ��daodea cr ntu° lana tJta, oa ,nil UqAwa. attau �u>s u daa.°rtale LLT iV- N: TIIAa O�p�0/6 QRANiD>'Bf) t�0a A V4LW1i1Ltd CON3ID11RAA71QQV, aeeelpa otti7�;°h la busby +do�orrledy.d, . - .. . Tf1ADMON CLUB w98041'8Q KC . s peGawAaa (tarited ($blllry a bPTb9(3MNT(8)w 08444 A. Noll and Xmmorine E. pall, huabtad and wile as jaipt tensato TEL:760 360 3080 ew w►p�p�yr ietla°cwRrL&Q0hM Cau4Q►d2Iwm* sawteofcdfottata, vda►a Ysa017107 (8BC EiAM "Ap A&IMLt i kerma) ppm April $. 1019 9naoorCaflrwas �� erbre nao, IUD C HISS L1C„ tDMW4 i a fC INS V 4aowt► 14 in fa.roy � Vitra 6e tlpo aauaE" whan aua�e(y i�4ee u�Kribe;0 to elu p wltwo +meat Md Ma"I"te4 6o ms"I'80 a med the ewne f+ hir/hetAleir tuthRriad ceparl411u1 >snd thar iy bladaeAil�°I, rit p Mee 00 bwft mt the tw+aWW w the eptly upon ho1wral' M: RVRrj =VICE FM a+IdpM t11C 1ialon am% asaaled ON UMMON. WfIA W MY "AM AND OMCIbL SPL s(peaovt�ti...fldid.,r. —�AIV4 A4.11 w"abM (11111 met Ib( arQBiginrial P. 001 002 1 10/28/99 THU 11:54 [TX/RX NO 99151 Z 002 Desert Sands Unified School District 47-950 Dune Palms Road Notice: La Quinta, CA 92253 Document Cannot Be Duplicated 760-771-8515 CERTIFICATE OF COMPLIANCE Date 11/12/99 No. 19595 Owner NameGerald Nell No. 52-945 Street Claret Cove City La Quinta Tract # Lot # APN # 769-180-020 Jurisdiction La Quinta Permit # Log # Zip 92253 Study Area Square Footage 3653 Type of Development Single Family Residence No. of Units 1 Comments At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patios/walkways, residential additions under 500 square feet, detached accessory structures or replacement mobilehomes. It has been determined the above-named owner is exempt from paying school fees at this time due to the following reason: EXEMPTION NOT APPLICABLE This certifies that school facility fees imposed pursuant to Government Code 53080 in the amount of 1.93 X 3,653 or $ 7,050.29 1 the property listed above and that building permits and/or Certificates of Occupancy for this square footage in this proposed project may now be issued Fees Paid By CC/M&I Northern Bank - Katherine Nell Telephone , Name on the check By Dr. Doris Wilson - Superintendent 'y Fee collected /exempted by Ellen Patino Payment Received ,ft'050:29'. \ ~ Signature C/ Check No. 350246 JOTICE: Pursuant of Assembly Bill 3081 (CHAP 549, STATS. 1996) this will serve to notify you that the 90 -day approval period in which you may protest the fees or other payment identified above will begin to run from the date on which the building or installation permit for this project is sssued or on which they are paid to the District(s) or to another public entity authorized to wllect them on the Disbict('s)(s') behalf, whichever is earlier. Collector: Attach a copy of county or city plan check application form to district copy for all waivers. Embossed Original- Building Dept./Applicant Copy - Applicant/Receipt Copy - Accounting f I CITY OF LA QUINTA SUB -CONTRACTOR LIST JOB ADDRESS 61?-gts dZ42 49V PERMIT NUMBER OWNER � `(A15ZC. BUILDER am-1l1-lew 7Qi� This form shall be posted on the job with the Building Inspection Card at all times in a conspicuous place. Only persons appearing on this list or their employees are authorized to work on this job. Any changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance of building permit. For each applicable t(ade, all information requested below must be completed by applicant. "On File" is not an acceptable response. rrada / Classification Contractor State Contractor's License Workers Com ansation Insurance City Busmass License Company Name C)usiriation (e.g. A. B. C-8) License Numbet Exp. Dots (xxxxxx) (ax/xxhx) Carrier Name (e.g. State Fund. CalComp) Policy Number IFormat Vries) Exp. Data (xx/xxrxx) License Number (xxxxl Exp. Data (xx/xx/xxl EARTHWORK (C-12) L!- 2Regy 1 a i 00 //5- ev TRADITION GOLF CLUB November 9, 1999 T 760 564 2356 11/09/99 16:005 :01/01 NO:457 Tradition ARCHITECTURAL DESIGN REVIEW Via First Class Mail and facsimile Mr. Greg Butler CnT OF LA QUINTA 78-495 Calle Tampico La Quinta, CA 92253 A Re: Nell Residence Lot 38, Tract 28867, 52-945 Claret Cove Dear Greg, Please accept this letter as approval for the above referenced residence to obtain a building permit. Conditions that apply to this submittal will be forwarded directly to the architect, Ms. Kristi Hanson. If you have any questions or need additional information, please do not hesitate to call. Thank you. Sincerely, Christina J. Dores Architectural Review Coordinator. pe: Krista Hanson, Architect Ken Hudson, General Contractor 78505 OLD Aveam 52 -- LA QuNrA — CA 92253.1120 PHONE 760/564-3355 --- FAx 760/564-2356 9 PUBLIC WORKS CLEARANCE LETTER FOR j CUSTOM HOME LOTS -I Dear Builder:. Prior to issuance of a building permit, 'you will be required to obtain' clearance from the Public Works Department for one, or more, of'the following: 1. Verification that rough grading is complete, and the pad elevation certifications - prepared . -by a licensed surveyor, or, engineer, are on file in the Public Works Department. 2: Verification that infrastructure improvements and other required tract -improvements are complete, or sufficiently advanced to warrant building permit issuance. .3. Prepare an engineered grading plan that provides. for on -lot storm water retention, .: and have it checked and approved by the Public Works Department,. • Tract 26524 (Estancias) Ic • Tract 26769 (Mountain View Estates) 4. Prepare an engineered grading plan that provides for building "pad grading in accordance with the existing soils report and tract grading plan, and . have It. r checked and approved by the Public Works Department." ' • Tract 28034 (South Valley Estates) ry/ • FOR INTERNAL USE BY PUBLIC WORKS DEPARTMENT TRACT: '� (ol LOT 3S 12 PUBL C WO U HORIZA ION IJAfE F:IPWDEPTIDOCS%FORMS%PW CLEARANCE LE TER.sz 4 M1 Tradition ARCHITECTURAL DESIGN REVIEW November 9, 1999 Mr. Greg Butler CITY OF LA QUINTA 78-495 Calle Tampico La Quinta, CA 92253 Re: Nell Residence Lot 38, Tract 28867, 52-945 Claret Cove Dear Greg, crrY OP I_A tee,►,��-A A10 2 2 RECD rY Via First Class Mail and facsimile Please accept this letter as approval for the above referenced residence to obtain a building permit. Conditions that apply to this submittal will be forwarded directly to the architect, Ms. Kristi Hanson. If you have any questions or need additional information, please do not hesitate to call. 'I Thank you. Sincerely, Christina J. Dores Architectural Review Coordinator pc: Kristi Hanson, Architect Ken Hudson, General Contractor j �.1:):4 U12- j'C.B:'i! Hul'?WT- i3GLIl1�:.' ut rrOU—, 1 i Tr ;-i:i' <� CO i 2;JC/ Tom" !J; c,�r r ('C7. 1',. -1 �1 ;? :+' `'f i.T `)C , I -f . qcq Ci 'GC.li� l(1 1ir� ., ,r r,(•,�" ?7 TO,'- r' car r� �... �. . �j !3 r :IiGi. d -x- Cali . i_ �F i'>�^l . I.�r?ic r(fl.T�:v� C"1� 31I: M1I '1)? 1') Z. r t'.r.' . C'WyDo —� ADRCOWLOR -N 78505 OLD AvENuE 52 -- LA QuINI'A -- CA 92253-1120 --- PHONE 760/564-3355 - FAx 760/564-2356 YO UNG ENGINEERING SERVICES 47159 Young Lane Indio, CA 92201 (760) 342-9214 March 20, 2000 Tom Hartung - Building Official City of La Quinta RE: Nell Residence Lot 38, Tract 28867 , La puinta Dear Tom, We have reviewed the framing for the above referenced project and find it to be in general conformance with the approved structural plans. If you have any questions please call. Sinc y, Jeffr B. Youn E.